Crit Care Resusc
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To review the physiology and cardiovascular effects of the commonly used intravenous electrolytes. ⋯ Intravenous potassium chloride, calcium chloride, magnesium sulphate, sodium and potassium phosphate, sodium bicarbonate and hypertonic saline can be used effectively to alter the haemodynamic status and manage cardiac arrhythmias. However, their indications are selective and complications may occur, so careful administration and monitoring are required with their use.
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To review the recent pharmacokinetic and pharmacodynamic reports of some of the commonly used antibiotics in critically ill patients and recommend alterations in their administration to improve their efficacy. ⋯ Applying pharmacokinetic and pharmacodynamic principles to critically ill patients will lead to better antibiotic use and hopefully a better outcome.
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To review recent studies in pathogenesis and management of ventilator-induced lung injury. ⋯ Ventilator-induced lung injury is an iatrogenic disturbance that increases morbidity and mortality associated with acute respiratory distress syndrome. Tidal volume reduction and increased levels of PEEP have reduced inflammatory mediators and the mortality associated with ARDS.
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To review the strategies for identification and subsequent management of high-risk patients that have been proposed to reduce perioperative morbidity and mortality. ⋯ In patients who are about to undergo major intra-abdominal surgery, preoperative cardiopulmonary exercise testing is an excellent predictor of risk in the postoperative period. No other test is able to offer such a comprehensive preoperative risk evaluation for an operative patient.